903 Septic Perc Tests & Plan 2000 ILea I
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PERCOLATION TEST(S)
Time: Time:
Observation Hole #1 Observation Hole #2
Depth of Perc n ti Depth of Perc
Start Pre-soak Start Pre-soak
End Pre-soak End Pre-soak
ii ;
Time at 17 Time at 12"
Time at 9° i
Time at 9'
Time at 6" Time at 6'
Time(9"—6') Tme(9"—6")
Rate Min./Inch Rate Min./Inch
'minimum of 1 percolation test must be performed in-oth the primary area AND reserve area.
• ..._:_.. ■ • •
Performed by I Performed by
Witnessed by Witnessed by
Comments:
J:_. _
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NORTHAMPTON BOARD of HEALTH- Title 5- Site Review
Location Address or Lot# ,ii / Owner r /,
dip i � _ i� -
Date Time
D 1 4)
Soil Holton
Owner's
Address
Sol Color
(Munsell)
Engineer I /IWptti
Weather Phone M.,
Land Use
Y Slope
Surface Stones
Landform
Ve!etation Start Time
PmiEm at Landscape(sketch
Open Water Body
co the bark)
feet
Distances Stop Time
Drinking Water Well
feet Property Line
feet
Possible Wet Area
feet
Drainage Way
feet Other
feet
DEEP OBSERVATION HOLE LOG*
Deep Hole N: 'MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Depth from
Surface(lathes)
Soil Holton
Soil Texture
(USDA)
Sol Color
(Munsell)
Soi
Motf g
Other
(Structure,Stones.Boulders.Consistency,%Greveg
L
Ii
v r�
1
02,6501/
I I/
Parent Mabial(geabglo) I I Depth to Bedrock
Depth to groundwater: Standup Waterinthe Hole
),i6),/'i-_. I Weeping from Pit Face
Estimated Seasonal High Ground Water
DEEP OBSERVATION HOLE LOG`
Deep Hole N: MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Depth from
Surface prates)
Sal Holton
Sail Texture
(USDA)
Sal Color
(Mansel)
Soil
Mottling
Other
(Structure,Stones,Boulders,Consstency,%Gravel)
Parent Mahal(geologc) I I Depth to Bedrock
Depth to gr undwater Standing Water in the Hole
I Weeping from Pit Face
Estim ted Seasonal High Ground Water
Property Addr
Owner:
Dee of
SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTON FORM
PART C
SYSTEM INFORMATION(continued)
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SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent reference landmarks or benchmarks
locate ell wells w'thin 100' (Locate where public wetee supply comes into house)
revised 9/2/56
35
46
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W-ov-xz. - 3 AC
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